International comparison of six basic eHealth indicators across 14 countries: an eHealth benchmarking study

Elske Ammenwerth*, Georg Duftschmid, Zaid Al-Hamdan, Hala Bawadi, Ngai T. Cheung, Kyung Hee Cho, Guillermo Goldfarb, Kemal H. Gülkesen, Nissim Harel, Michio Kimura, Önder Klrca, Hiroshi Kondoh, Sabine Koch, Hadas Lewy, Dara Mize, Sari Palojoki, Hyeoun Ae Park, Christopher Pearce, Fernan G. B. De Quirós, Kaija SarantoChristoph Seidel, Vivian Vimarlund, Martin C. Were, Johanna Westbrook, Chung P. Wong, Reinhold Haux, Christoph U. Lehmann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
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Background  Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country. The eHealth indicators focusing on the cross-institutional availability of patient-related information for health care professionals, patients, and care givers are rare. Objectives  This study aims to present eHealth indicators on cross-institutional availability of relevant patient data for health care professionals, as well as for patients and their caregivers across 14 countries (Argentina, Australia, Austria, Finland, Germany, Hong Kong as a special administrative region of China, Israel, Japan, Jordan, Kenya, South Korea, Sweden, Turkey, and the United States) to compare our indicators and the resulting data for the examined countries with other eHealth benchmarks and to extend and explore changes to a comparable survey in 2017. We defined availability of patient data as the ability to access data in and to add data to the patient record in the respective country. Methods  The invited experts from each of the 14 countries provided the indicator data for their country to reflect the situation on August 1, 2019, as date of reference. Overall, 60 items were aggregated to six eHealth indicators. Results  Availability of patient-related information varies strongly by country. Health care professionals can access patients' most relevant cross-institutional health record data fully in only four countries. Patients and their caregivers can access their health record data fully in only two countries. Patients are able to fully add relevant data only in one country. Finland showed the best outcome of all eHealth indicators, followed by South Korea, Japan, and Sweden. Conclusion  Advancement in eHealth depends on contextual factors such as health care organization, national health politics, privacy laws, and health care financing. Improvements in eHealth indicators are thus often slow. However, our survey shows that some countries were able to improve on at least some indicators between 2017 and 2019. We anticipate further improvements in the future.

Original languageEnglish
Article number20010041
Pages (from-to)E46-E63
Number of pages18
JournalMethods of Information in Medicine
Issue numberS 02
Publication statusPublished - 1 Dec 2020

Bibliographical note

Copyright the Publisher 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • continuity of patient care
  • eHealth
  • health information exchange
  • health information systems
  • international health
  • patient-centered care


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